Differences in Graft Rupture and Subsequent Meniscal Tears Following Adolescent ACL Reconstruction Using Quadriceps...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Pediatric Orthopedics

Background:

• Anterior cruciate ligament reconstruction (ACLR) in adolescents is crucial for knee stability.
• Quadriceps tendon (QT) autografts show promise for lower graft rupture rates and better outcomes than hamstring (HS) autografts.
• The risk of secondary injuries, like meniscal tears, after ACLR requires further investigation for different graft types.

Purpose of the Study:

• To compare graft rupture rates after adolescent ACLR using HS versus QT autografts.
• To evaluate and compare the incidence of subsequent meniscal tears in adolescent patients undergoing ACLR with HS or QT autografts.

Main Methods:

• Retrospective cohort study of 467 adolescent patients (ages 10-19) who underwent ACLR with either HS or QT autograft.
• Inclusion criteria required a minimum of 2 years of clinical follow-up.
• Statistical analysis, including multivariable logistic regression, was used to compare graft failure and meniscal tear rates between the HS and QT groups.

Main Results:

• Graft rupture was significantly lower in the QT group (7.2%) compared to the HS group (23.2%) (P < .001).
• The rate of subsequent meniscal tears did not differ significantly between the QT (4.6%) and HS (9.2%) groups (P = .08).
• Regression analysis confirmed QT graft type was associated with a lower risk of graft failure (OR, 0.29; P < .001) but not subsequent meniscal tears (OR, 0.47; P = .09).

Conclusions:

• Adolescent ACLR with QT autograft offers a significantly reduced risk of graft rupture compared to HS autograft.
• There is no statistically significant difference in the rate of subsequent meniscal tears between QT and HS autografts in this adolescent population.